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Nursing Home Neglect: Watch for These Red Flags

October 9, 2018

When a loved one is in a nursing home, it’s only natural that you want him or her to receive the highest-quality care. To help ensure that, the Nursing Home Reform Act became law in 1987, requiring nursing homes provide the “highest practicable” degrees of care needed to achieve and maintain the physical, mental, and psychosocial well-being of residents.

That act also established basic rights for nursing home patients, which include:

The right to freedom from abuse, mistreatment, and neglect;

The right to freedom from physical restraints;

The right to privacy;

The right to accommodation of medical, physical, psychological, and social needs;

The right to participate in resident and family groups;

The right to be treated with dignity;

The right to exercise self-determination;

The right to communicate freely;

The right to participate in the review of one’s care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and

The right to voice grievances without discrimination or reprisal.

While many nursing homes do provide excellent care, neglect clearly exists at some of these facilities. To help protect your loved one, here are eight red flags to watch for.

#1 Unsanitary Living Conditions

When you visit your relative or friend, if you notice that his or her room doesn’t look clean or doesn’t smell fresh, or public areas of the facility also lack cleanliness, this is a red flag, and one of the easiest to spot. Your loved one is entitled to have fresh bedding, as well as a sanitary bathroom. Is that the case? When you eat a meal with your loved one in the cafeteria, how clean is that area? Are there any food particles on dishes or cloudy-looking glasses? If you have any concerns about cleanliness, this is a sign of potential nursing home neglect.

#2 Personal Hygiene Concerns

In a nursing home, residents are entitled to help with personal hygiene, and it isn’t uncommon for staff to need to help them to bathe, brush teeth, wash and comb hair, clip nails, get appropriately dressed and more. If you notice that your loved one’s personal hygiene is less than it should be, it’s a concerning sign that the nursing home does not have enough staff or the staff is not being trained in the standards of care required or taught how to help residents maintain proper hygiene.

#3 Concerns About the Nursing Home Staff

Red flag #2 naturally leads into this one. If there seems to be a lack of staff when you visit or if the people caring for your loved one usually seem hurried and frazzled, this is yet another area of concern. Have you met the facility’s director—ever? If so, have you ever seen him or her after your relative was first brought there?

Do you notice that, each time you visit, there seems to be different people working at the nursing home? High staff turnover can be an issue at some nursing homes, even to the point that important information about residents’ care may not be shared as it should when shift changes occur.

#4 Unanswered Calls for Help

Different nursing homes have different systems for residents to summon help. Some prefer call lights while others ask residents to use the phone when they have an issue. Regardless of the system in place, if you notice that phones seem to keep ringing and call lights keep blinking, that’s not a good sign.

If your relative says that he or she never seems to get a response, that’s another red flag, and it wouldn’t hurt for you to test the system on your next visit. If you call for assistance, how long does it take for a response? If you’re not satisfied with response time, how does the staff respond when you express concern?

#5 Concerns About Adequate Nutrition

Perhaps your loved one has issues with swallowing or maybe he or she forgets to eat because of challenges with dementia. Or perhaps depression is an issue and your relative needs to be encouraged to eat and drink enough. If you notice that your loved one appears to be suffering from nutritional or hydration issues, this is a serious concern. Sometimes, inadequate staffing is the underlying problem, because it prevents enough one-on-one care for residents. Other times, there just isn’t enough food and drink provided. No matter the cause, though, nursing homes are required to ensure proper nutrition for their residents.

#6 Complaints From Your Loved One

If your parent or grandparent complains about the level of care he or she is receiving, this may be a sign of neglect. You know your loved one better than the nursing home staff, so consider whether the complaints seem typical for them (maybe Dad has always liked to fuss about his food) or if the complaints are unusual. If you hear a normal amount of complaints, with “normal” being defined differently for each person, start to pay closer attention, just in case that neglect is occurring, and ask staff what can be done to alleviate the issue.

If the complaints are more significant, however, perhaps about a fall or other injury, or if complaints are frequently made, investigate the issue more thoroughly. This is even more crucial if your loved one is experiencing cognitive decline and can’t necessarily advocate for himself or herself as well anymore.

#7 Significant Changes in Your Loved One

Changes may be physical, emotional, social or psychological, or they may be a combination of one or more of these types. But if changes are marked, this is a cause for concern. They are not always related to nursing home neglect, but definitely can be. Sometimes, for example, a loss of weight may be connected to a decline in health, while agitation may be a sign of deepening dementia.

It’s important to pay close attention to these changes and talk to the staff often to help ensure they’re paying close attention, too. If you aren’t satisfied with how the staff responds, then consider visiting more often, perhaps at times you don’t normally show up, just to check on how your loved one is doing. If your parent or grandparent seems anxious or afraid, continue to investigate and seek help, as needed.

#8 Increasing Numbers of Injuries, Often Unexplained

Ask staff for explanations any time your loved one has cuts, bruises and the like, and keep track of how often they happen. Does this mean that he or she needs more help because of lessening strength? Do residents in the nursing home get enough exercise to maintain muscle tone and balance?

Serious red flags can include head injuries, broken bones and bed sores. Any time a loved one experiences any of the above, this can be a significant red flag, especially if the nursing home didn’t contact family to explain what happened, how he or she was treated for the condition, and what the plan is to prevent any future incidents from taking place, including but not limited to fall prevention strategies.

How to Respond to Concerns about Nursing Home Neglect

The first step, typically, is to talk to nursing home staff to see what solutions they recommend and to create a plan. And, for many concerns, this is enough. But, if you don’t get the prompt attention you need or if the signs of neglect are significant, even crossing over into nursing home neglect, then the time for conversations with staff is over.

Harrell & Harrell has served as a community leader and advocate for the rights of nursing home patients, with our legal team lobbying for reform, even testifying before Congress and the Florida State Legislature about concerns over nursing home abuse and accidents.

If you need an exceptionally well-qualified nursing home abuse lawyer to advocate for and represent your loved one, we highly recommend our experienced case leader, Julie Harrell. From the earliest stages of her practice, she has taken special interest in the elderly, personally handling dozens of nursing home neglect and abuse cases.

Her wealth of knowledge about the standards of care in nursing homes, as well as what is required in daily operations there, will be invaluable as she assists you in seeking compensation. You can find more information about our nursing home abuse lawyers as well as settlements we have received for clients.

Plus, here are other areas where you may be entitled to seek compensation for personal damages: